U.S. Trustee Basic Monthly Operating Report
UNITED STATES BANKRUPTCY COURT
________________ DISTRICT OF ___________________
________________ DIVISION
IN RE:
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DEBTOR.
CASE NUMBER
JUDGE
CHAPTER 11
DEBTOR'S STANDARD MONTHLY OPERATING REPORT (BUSINESS)
FROM
FOR THE PERIOD
TO
Comes now the above-named debtor and files its Monthly Operating Reports in accordance with the
Guidelines established by the United States Trustee and FRBP 2015.
Attorney for Debtor’ s Signature
Debtor's Address
and Phone Number:
Attorney's Address
and Phone Number:
Note: The original Monthly Operating Report is to be filed with the court and a copy simultaneously
provided to the United States Trustee Office. Monthly Operating Reports must be filed by the 20th day of
the following month.
For assistance in preparing the Monthly Operating Report, refer to the following resources on the United
States Trustee Program Website, http://www.usdoj.gov/ust/r21/reg_info.htm
1)
Instructions for Preparations of Debtor’ s Chapter 11 Monthly Operating Report
2)
Initial Filing Requirements
3)
Frequently Asked Questions (FAQs)http://www.usdoj.gov/ust/.
MOR-1
SCHEDULE OF RECEIPTS AND DISBURSEMENTS
FOR THE PERIOD BEGINNING
AND ENDING
Name of Debtor:
Date of Petition:
Case Number
CURRENT
MONTH
1. FUNDS AT BEGINNING OF PERIOD
2. RECEIPTS:
A. Cash Sales
Minus: Cash Refunds
Net Cash Sales
B. Accounts Receivable
C. Other Receipts (See MOR-3)
(If you receive rental income,
you must attach a rent roll.)
3. TOTAL RECEIPTS (Lines 2A+2B+2C)
4. TOTAL FUNDS AVAILABLE FOR
OPERATIONS (Line 1 + Line 3)
CUMULATIVE
PETITION TO DATE
(a)
(b)
(-)
5. DISBURSEMENTS
A. Advertising
B. Bank Charges
C. Contract Labor
D. Fixed Asset Payments (not incl. in “N”)
E. Insurance
F. Inventory Payments (See Attach. 2)
G. Leases
H. Manufacturing Supplies
I. Office Supplies
J. Payroll - Net (See Attachment 4B)
K. Professional Fees (Accounting & Legal)
L. Rent
M. Repairs & Maintenance
N. Secured Creditor Payments (See Attach. 2)
O. Taxes Paid - Payroll (See Attachment 4C)
P. Taxes Paid - Sales & Use (See Attachment 4C)
Q. Taxes Paid - Other (See Attachment 4C)
R. Telephone
S. Travel & Entertainment
Y. U.S. Trustee Quarterly Fees
U. Utilities
V. Vehicle Expenses
W. Other Operating Expenses (See MOR-3)
6. TOTAL DISBURSEMENTS (Sum of 5A thru W)
7. ENDING BALANCE (Line 4 Minus Line 6)
tnmhecaSROM
(c)
(c)
I declare under penalty of perjury that this statement and the accompanying documents and reports are true
and correct to the best of my knowledge and belief.
This
day of
, 20
.
(Signature)
(a)This number is carried forward from last month’s report. For the first report only, this number will be the
balance as of the petition date.
(b)This figure will not change from month to month. It is always the amount of funds on hand as of the date of
the petition.
(c)These two amounts will always be the same if form is completed correctly.
MOR-2
MONTHLY SCHEDULE OF RECEIPTS AND DISBURSEMENTS (cont’d)
Detail of Other Receipts and Other Disbursements
OTHER RECEIPTS:
Describe Each Item of Other Receipt and List Amount of Receipt. Write totals on Page MOR-2, Line 2C.
Description
Current Month
Cumulative
Petition to Date
yxwvutsrpon
TOTAL OTHER RECEIPTS
________________
_________________
“Other Receipts” includes Loans from Insiders and other sources (i.e. Officer/Owner, related parties
directors, related corporations, etc.). Please describe below:
Loan Amount
Source
of Funds
Purpose
___________________
Repayment Schedule
__________________
OTHER DISBURSEMENTS:
Describe Each Item of Other Disbursement and List Amount of Disbursement. Write totals on Page MOR-2, Line
5W.
Cumulative
Description
Current Month
Petition to Date
TOTAL OTHER DISBURSEMENTS
______________
________________
NOTE: Attach a current Balance Sheet and Income (Profit & Loss) Statement.
MOR-3
ATTACHMENT 1
MONTHLY ACCOUNTS RECEIVABLE RECONCILIATION AND AGING
Name of Debtor:
Case Number:
Reporting Period beginning
Period ending
ACCOUNTS RECEIVABLE AT PETITION DATE:
ACCOUNTS RECEIVABLE RECONCILIATION
(Include all accounts receivable, pre-petition and post-petition, including charge card sales which have
not been received):
Beginning of Month Balance
PLUS: Current Month New Billings
MINUS: Collection During the Month
PLUS/MINUS: Adjustments or Writeoffs
End of Month Balance
$
(a)
$
$
$
(b)
*
(c)
*For any adjustments or Write-offs provide explanation and supporting documentation, if applicable:
POST PETITION ACCOUNTS RECEIVABLE AGING
(Show the total for each aging category for all accounts receivable)
0-30 Days
$
31-60 Days
$
61-90 Days
$
Over 90Days Total
$
$
(c)
For any receivables in the “ Over 90 Days” category, please provide the following:
Customer
Receivable
Date
Status (Collection efforts taken, estimate of collectibility,
write-off, disputed account, etc.)
(a)This number is carried forward from last month’ s report. For the first report only, this number will be
the balance as of the petition date.
(b)This must equal the number reported in the “ Current Month” column of Schedule of Receipts and
Disbursements (Page MOR-2, Line 2B).
(c)These two amounts must equal.
MOR-4
ATTACHMENT 2
MONTHLY ACCOUNTS PAYABLE AND SECURED PAYMENTS REPORT
Name of Debtor:
Case Number:
Reporting Period beginning
Period ending
In the space below list all invoices or bills incurred and not paid since the filing of the petition. Do not include
amounts owed prior to filing the petition. In the alternative, a computer generated list of payables may be attached
provided all information requested below is included.
POST-PETITION ACCOUNTS PAYABLE
Date
Days
Incurred
Outstanding
Vendor
Description
Amount
TOTAL AMOUNT
☐ Check here if pre-petition debts have been paid. Attach an explanation and copies of supporting
documentation.
(b)
ACCOUNTS PAYABLE RECONCILIATION (Post Petition Unsecured Debt Only)
Opening Balance
$
(a)
PLUS: New Indebtedness Incurred This Month $
MINUS: Amount Paid on Post Petition,
Accounts Payable This Month
$
PLUS/MINUS: Adjustments
$
*
Ending Month Balance
$
(c)
*For any adjustments provide explanation and supporting documentation, if applicable.
SECURED PAYMENTS REPORT
List the status of Payments to Secured Creditors and Lessors (Post Petition Only). If you have entered into a
modification agreement with a secured creditor/lessor, consult with your attorney and the United States Trustee
Program prior to completing this section).
Number
Total
Date
of Post
Amount of
Secured
Payment
Amount
Petition
Post Petition
Creditor/
Due This
Paid This
Payments
Payments
Lessor
Month
Month
Delinquent
Delinquent
TOTAL
(d)
(a)This number is carried forward from last month’s report. For the first report only, this number will be zero.
(b, c)The total of line (b) must equal line (c).
(d)This number is reported in the “Current Month” column of Schedule of Receipts and Disbursements (Page MOR-2, Line 5N).
MOR-5
ATTACHMENT 3
INVENTORY AND FIXED ASSETS REPORT
Name of Debtor:
Case Number:
Reporting Period beginning
Period ending
INVENTORY REPORT
INVENTORY BALANCE AT PETITION DATE:
INVENTORY RECONCILIATION:
Inventory Balance at Beginning of Month
PLUS: Inventory Purchased During Month
MINUS: Inventory Used or Sold
PLUS/MINUS: Adjustments or Write-downs
Inventory on Hand at End of Month
$
$
$
$
$
$
(a)
*
METHOD OF COSTING INVENTORY:
*For any adjustments or write-downs provide explanation and supporting documentation, if applicable.
INVENTORY AGING
Less than 6
months old
6 months to
2 years old
%
Greater than
2 years old
%
Considered
Obsolete
%
%
Total Inventory
=
100%*
* Aging Percentages must equal 100%.
☐ Check here if inventory contains perishable items.
Description of Obsolete Inventory:
FIXED ASSET REPORT
FIXED ASSETS FAIR MARKET VALUE AT PETITION DATE:
(Includes Property, Plant and Equipment)
(b)
BRIEF DESCRIPTION (First Report Only):
FIXED ASSETS RECONCILIATION:
Fixed Asset Book Value at Beginning of Month
MINUS: Depreciation Expense
PLUS: New Purchases
PLUS/MINUS: Adjustments or Write-downs
Ending Monthly Balance
$
$
$
$
$
(a)(b)
*
*For any adjustments or write-downs, provide explanation and supporting documentation, if applicable.
BRIEF DESCRIPTION OF FIXED ASSETS PURCHASED OR DISPOSED OF DURING THE REPORTING
PERIOD:
(a)This number is carried forward from last month’s report. For the first report only, this number will be the
balance as of the petition date.
(b)Fair Market Value is the amount at which fixed assets could be sold under current economic conditions.
Book Value is the cost of the fixed assets minus accumulated depreciation and other adjustments.
MOR-6
ATTACHMENT 4A
MONTHLY SUMMARY OF BANK ACTIVITY - OPERATING ACCOUNT
Name of Debtor:
Case Number:
Reporting Period beginning
Period ending
Attach a copy of current month bank statement and bank reconciliation to this Summary of Bank Activity. A
standard bank reconciliation form can be found at http://www.usdoj.gov/ust/r21/reg_info.htm. If bank accounts
other than the three required by the United States Trustee Program are necessary, permission must be obtained from
the United States Trustee prior to opening the accounts. Additionally, use of less than the three required bank
accounts must be approved by the United States Trustee.
NAME OF BANK:
BRANCH:
ACCOUNT NAME:
ACCOUNT NUMBER:
PURPOSE OF ACCOUNT:
OPERATING
Ending Balance per Bank Statement
Plus Total Amount of Outstanding Deposits
Minus Total Amount of Outstanding Checks and other debits
Minus Service Charges
Ending Balance per Check Register
$
$
$
$
$
*
**(a)
*Debit cards are used by
**If Closing Balance is negative, provide explanation:
The following disbursements were paid in Cash (do not includes items reported as Petty Cash on Attachment
4D: ( ☐ Check here if cash disbursements were authorized by United States Trustee)
Date
Amount
Payee
Purpose
Reason for Cash Disbursement
TRANSFERS BETWEEN DEBTOR IN POSSESSION ACCOUNTS
“Total Amount of Outstanding Checks and other debits”, listed above, includes:
$________________Transferred to Payroll Account
$________________Transferred to Tax Account
(a) The total of this line on Attachment 4A, 4B and 4C plus the total of 4D must equal the amount reported as
“Ending Balance” on Schedule of Receipts and Disbursements (Page MOR-2, Line 7).
MOR-7
ATTACHMENT 5A
CHECK REGISTER - OPERATING ACCOUNT
Name of Debtor:
Case Number:
Reporting Period beginning
Period ending
NAME OF BANK:
BRANCH:
ACCOUNT NAME:
ACCOUNT NUMBER:
PURPOSE OF ACCOUNT:
OPERATING
Account for all disbursements, including voids, lost checks, stop payments, etc. In the
alternative, a computer generated check register can be attached to this report, provided all the
information requested below is included.
DATE
CHECK
NUMBER
PAYEE
PURPOSE
TOTAL
AMOUNT
$
MOR-8
ATTACHMENT 4B
MONTHLY SUMMARY OF BANK ACTIVITY - PAYROLL ACCOUNT
Name of Debtor:
Case Number:
Reporting Period beginning
Period ending
Attach a copy of current month bank statement and bank reconciliation to this Summary of Bank Activity.
A standard bank reconciliation form can be found at http://www.usdoj.gov/ust/r21/reg_info.htm.
NAME OF BANK:
BRANCH:
ACCOUNT NAME:
PURPOSE OF ACCOUNT:
ACCOUNT NUMBER:
PAYROLL
Ending Balance per Bank Statement
Plus Total Amount of Outstanding Deposits
Minus Total Amount of Outstanding Checks and other debits
Minus Service Charges
Ending Balance per Check Register
$
$
$
$
$
*
**(a)
*Debit cards must not be issued on this account.
**If Closing Balance is negative, provide explanation:
The following disbursements were paid by Cash: ( ☐ Check here if cash disbursements were authorized
by United States Trustee)
Date
Amount
Payee
Purpose
Reason for Cash Disbursement
The following non-payroll disbursements were made from this account:
Date
Amount
Payee
Purpose
Reason for disbursement from this
account
_____
_____
_____
(a)The total of this line on Attachment 4A, 4B and 4C plus the total of 4D must equal the amount reported as
“Ending Balance” on Schedule of Receipts and Disbursements (Page MOR-2, Line 7).
MOR-9
ATTACHMENT 5B
CHECK REGISTER - PAYROLL ACCOUNT
Name of Debtor:
Case Number:
Reporting Period beginning
Period ending
NAME OF BANK:
BRANCH:
ACCOUNT NAME:
ACCOUNT NUMBER:
PURPOSE OF ACCOUNT:
PAYROLL
Account for all disbursements, including voids, lost payments, stop payment, etc. In the
alternative, a computer generated check register can be attached to this report, provided all the
information requested below is included.
DATE
CHECK
NUMBER
PAYEE
PURPOSE
TOTAL
AMOUNT
$
MOR-10
ATTACHMENT 4C
MONTHLY SUMMARY OF BANK ACTIVITY - TAX ACCOUNT
Name of Debtor:
Case Number:
Reporting Period beginning
Period ending
Attach a copy of current month bank statement and bank reconciliation to this Summary of Bank Activity. A
standard bank reconciliation form can be found on the United States Trustee website,
http://www.usdoj.gov/ust/r21/index.htm.
NAME OF BANK:
BRANCH:
ACCOUNT NAME:
ACCOUNT NUMBER:
PURPOSE OF ACCOUNT:
TAX
Ending Balance per Bank Statement
$
Plus Total Amount of Outstanding Deposits
$
Minus Total Amount of Oustanding Checks and other debits $
Minus Service Charges
$
Ending Balance per Check Register
$
*
**(a)
*Debit cards must not be issued on this account.
**If Closing Balance is negative, provide explanation:
The following disbursements were paid by Cash: ( ☐ Check here if cash disbursements were authorized by
United States Trustee)
Date
Amount
Payee
Purpose
Reason for Cash Disbursement
The following non-tax disbursements were made from this account:
Date
Amount
Payee
Purpose
Reason for disbursement from this account
(a)The total of this line on Attachment 4A, 4B and 4C plus the total of 4D must equal the amount reported as
“Ending Balance” on Schedule of Receipts and Disbursements (Page MOR-2, Line 7).
MOR-11
ATTACHMENT 5C
CHECK REGISTER - TAX ACCOUNT
Name of Debtor:
Case Number:
Reporting Period beginning
Period ending
NAME OF BANK:
BRANCH:
ACCOUNT NAME:
ACCOUNT #
PURPOSE OF ACCOUNT:
TAX
Account for all disbursements, including voids, lost checks, stop payments, etc. In the
alternative, a computer-generated check register can be attached to this report, provided all the
information requested below is included.
http://www.usdoj.gov/ust.
CHECK
DATE NUMBER
PAYEE
PURPOSE
AMOUNT
TOTAL
(d)
SUMMARY OF TAXES PAID
Payroll Taxes Paid
Sales & Use Taxes Paid
Other Taxes Paid
TOTAL
(a)
(b)
(c)
_________ (d)
(a) This number is reported in the “ Current Month” column of Schedule of Receipts and Disbursements
(Page MOR-2, Line 5O).
(b) This number is reported in the “ Current Month” column of Schedule or Receipts and Disbursements
(Page MOR-2, Line 5P).
(c) This number is reported in the “ Current Month” column of Schedule of Receipts and Disbursements
(Page MOR-2, Line 5Q).
(d) These two lines must be equal.
MOR-12
ATTACHMENT 4D
INVESTMENT ACCOUNTS AND PETTY CASH REPORT
INVESTMENT ACCOUNTS
Each savings and investment account, i.e. certificates of deposits, money market accounts, stocks
and bonds, etc., should be listed separately. Attach copies of account statements.
Type of Negotiable
Instrument
Face Value
Purchase Price
Date of Purchase
Current
Market Value
TOTAL
(a)
PETTY CASH REPORT
The following Petty Cash Drawers/Accounts are maintained:
Location of
Box/Account
TOTAL
(Column 2)
Maximum
Amount of Cash
in Drawer/Acct.
(Column 3)
(Column 4)
Amount of Petty
Difference between
Cash On Hand (Column 2) and
At End of Month
(Column 3)
$
(b)
For any Petty Cash Disbursements over $100 per transaction, attach copies of receipts. If
there are no receipts, provide an explanation
TOTAL INVESTMENT ACCOUNTS AND PETTY CASH(a + b)
$
(c)The total of this line on Attachment 4A, 4B and 4C plus the total of 4D must equal the
amount reported as “Ending Balance” on Schedule of Receipts and Disbursements (Page
MOR-2, Line 7).
MOR-13
(c)
ATTACHMENT 6
MONTHLY TAX REPORT
Name of Debtor:
Case Number:
Reporting Period beginning
Period ending
TAXES OWED AND DUE
Report all unpaid post-petition taxes including Federal and State withholding FICA, State sales
tax, property tax, unemployment tax, State workmen's compensation, etc.
Name of
Taxing
Authority
TOTAL
Date
Payment
Due
Description
Amount
$
MOR-14
Date Last
Tax Return
Filed
Tax Return
Period
ATTACHMENT 7
SUMMARY OF OFFICER OR OWNER COMPENSATION
SUMMARY OF PERSONNEL AND INSURANCE COVERAGES
Name of Debtor:
Case Number:
Reporting Period beginning
Period ending
Report all forms of compensation received by or paid on behalf of the Officer or Owner during the month. Include
car allowances, payments to retirement plans, loan repayments, payments of Officer/Owner’s personal expenses,
insurance premium payments, etc. Do not include reimbursement for business expenses Officer or Owner incurred
and for which detailed receipts are maintained in the accounting records.
Payment
Name of Officer or Owner
Title
Description
Amount Paid
PERSONNEL REPORT
Full Time
_________
Number of employees at beginning of period
Number hired during the period
Number terminated or resigned during period
Number of employees on payroll at end of period
Part Time
_________
CONFIRMATION OF INSURANCE
List all policies of insurance in effect, including but not limited to workers' compensation, liability, fire, theft,
comprehensive, vehicle, health and life. For the first report, attach a copy of the declaration sheet for each type of
insurance. For subsequent reports, attach a certificate of insurance for any policy in which a change occurs during
the month (new carrier, increased policy limits, renewal, etc.).
Agent
and/or
Carrier
Phone
Number
Policy
Number
Coverage
Type
Expiration
Date
Date
Premium
Due
__________
The following lapse in insurance coverage occurred this month:
Policy
Type
Date
Lapsed
Date
Reinstated
Reason for Lapse
Check here if U. S. Trustee has been listed as Certificate Holder for all insurance policies.
MOR-15
ATTACHMENT 8
SIGNIFICANT DEVELOPMENTS DURING REPORTING PERIOD
Information to be provided on this page, includes, but is not limited to: (1) financial transactions that are not
reported on this report, such as the sale of real estate (attach closing statement); (2) non-financial transactions, such
as the substitution of assets or collateral; (3) modifications to loan agreements; (4) change in senior management,
etc. Attach any relevant documents.
We anticipate filing a Plan of Reorganization and Disclosure Statement on or before
MOR-16
.
________________ DISTRICT OF ___________________
________________ DIVISION
IN RE:
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DEBTOR.
CASE NUMBER
JUDGE
CHAPTER 11
DEBTOR'S STANDARD MONTHLY OPERATING REPORT (BUSINESS)
FROM
FOR THE PERIOD
TO
Comes now the above-named debtor and files its Monthly Operating Reports in accordance with the
Guidelines established by the United States Trustee and FRBP 2015.
Attorney for Debtor’ s Signature
Debtor's Address
and Phone Number:
Attorney's Address
and Phone Number:
Note: The original Monthly Operating Report is to be filed with the court and a copy simultaneously
provided to the United States Trustee Office. Monthly Operating Reports must be filed by the 20th day of
the following month.
For assistance in preparing the Monthly Operating Report, refer to the following resources on the United
States Trustee Program Website, http://www.usdoj.gov/ust/r21/reg_info.htm
1)
Instructions for Preparations of Debtor’ s Chapter 11 Monthly Operating Report
2)
Initial Filing Requirements
3)
Frequently Asked Questions (FAQs)http://www.usdoj.gov/ust/.
MOR-1
SCHEDULE OF RECEIPTS AND DISBURSEMENTS
FOR THE PERIOD BEGINNING
AND ENDING
Name of Debtor:
Date of Petition:
Case Number
CURRENT
MONTH
1. FUNDS AT BEGINNING OF PERIOD
2. RECEIPTS:
A. Cash Sales
Minus: Cash Refunds
Net Cash Sales
B. Accounts Receivable
C. Other Receipts (See MOR-3)
(If you receive rental income,
you must attach a rent roll.)
3. TOTAL RECEIPTS (Lines 2A+2B+2C)
4. TOTAL FUNDS AVAILABLE FOR
OPERATIONS (Line 1 + Line 3)
CUMULATIVE
PETITION TO DATE
(a)
(b)
(-)
5. DISBURSEMENTS
A. Advertising
B. Bank Charges
C. Contract Labor
D. Fixed Asset Payments (not incl. in “N”)
E. Insurance
F. Inventory Payments (See Attach. 2)
G. Leases
H. Manufacturing Supplies
I. Office Supplies
J. Payroll - Net (See Attachment 4B)
K. Professional Fees (Accounting & Legal)
L. Rent
M. Repairs & Maintenance
N. Secured Creditor Payments (See Attach. 2)
O. Taxes Paid - Payroll (See Attachment 4C)
P. Taxes Paid - Sales & Use (See Attachment 4C)
Q. Taxes Paid - Other (See Attachment 4C)
R. Telephone
S. Travel & Entertainment
Y. U.S. Trustee Quarterly Fees
U. Utilities
V. Vehicle Expenses
W. Other Operating Expenses (See MOR-3)
6. TOTAL DISBURSEMENTS (Sum of 5A thru W)
7. ENDING BALANCE (Line 4 Minus Line 6)
tnmhecaSROM
(c)
(c)
I declare under penalty of perjury that this statement and the accompanying documents and reports are true
and correct to the best of my knowledge and belief.
This
day of
, 20
.
(Signature)
(a)This number is carried forward from last month’s report. For the first report only, this number will be the
balance as of the petition date.
(b)This figure will not change from month to month. It is always the amount of funds on hand as of the date of
the petition.
(c)These two amounts will always be the same if form is completed correctly.
MOR-2
MONTHLY SCHEDULE OF RECEIPTS AND DISBURSEMENTS (cont’d)
Detail of Other Receipts and Other Disbursements
OTHER RECEIPTS:
Describe Each Item of Other Receipt and List Amount of Receipt. Write totals on Page MOR-2, Line 2C.
Description
Current Month
Cumulative
Petition to Date
yxwvutsrpon
TOTAL OTHER RECEIPTS
________________
_________________
“Other Receipts” includes Loans from Insiders and other sources (i.e. Officer/Owner, related parties
directors, related corporations, etc.). Please describe below:
Loan Amount
Source
of Funds
Purpose
___________________
Repayment Schedule
__________________
OTHER DISBURSEMENTS:
Describe Each Item of Other Disbursement and List Amount of Disbursement. Write totals on Page MOR-2, Line
5W.
Cumulative
Description
Current Month
Petition to Date
TOTAL OTHER DISBURSEMENTS
______________
________________
NOTE: Attach a current Balance Sheet and Income (Profit & Loss) Statement.
MOR-3
ATTACHMENT 1
MONTHLY ACCOUNTS RECEIVABLE RECONCILIATION AND AGING
Name of Debtor:
Case Number:
Reporting Period beginning
Period ending
ACCOUNTS RECEIVABLE AT PETITION DATE:
ACCOUNTS RECEIVABLE RECONCILIATION
(Include all accounts receivable, pre-petition and post-petition, including charge card sales which have
not been received):
Beginning of Month Balance
PLUS: Current Month New Billings
MINUS: Collection During the Month
PLUS/MINUS: Adjustments or Writeoffs
End of Month Balance
$
(a)
$
$
$
(b)
*
(c)
*For any adjustments or Write-offs provide explanation and supporting documentation, if applicable:
POST PETITION ACCOUNTS RECEIVABLE AGING
(Show the total for each aging category for all accounts receivable)
0-30 Days
$
31-60 Days
$
61-90 Days
$
Over 90Days Total
$
$
(c)
For any receivables in the “ Over 90 Days” category, please provide the following:
Customer
Receivable
Date
Status (Collection efforts taken, estimate of collectibility,
write-off, disputed account, etc.)
(a)This number is carried forward from last month’ s report. For the first report only, this number will be
the balance as of the petition date.
(b)This must equal the number reported in the “ Current Month” column of Schedule of Receipts and
Disbursements (Page MOR-2, Line 2B).
(c)These two amounts must equal.
MOR-4
ATTACHMENT 2
MONTHLY ACCOUNTS PAYABLE AND SECURED PAYMENTS REPORT
Name of Debtor:
Case Number:
Reporting Period beginning
Period ending
In the space below list all invoices or bills incurred and not paid since the filing of the petition. Do not include
amounts owed prior to filing the petition. In the alternative, a computer generated list of payables may be attached
provided all information requested below is included.
POST-PETITION ACCOUNTS PAYABLE
Date
Days
Incurred
Outstanding
Vendor
Description
Amount
TOTAL AMOUNT
☐ Check here if pre-petition debts have been paid. Attach an explanation and copies of supporting
documentation.
(b)
ACCOUNTS PAYABLE RECONCILIATION (Post Petition Unsecured Debt Only)
Opening Balance
$
(a)
PLUS: New Indebtedness Incurred This Month $
MINUS: Amount Paid on Post Petition,
Accounts Payable This Month
$
PLUS/MINUS: Adjustments
$
*
Ending Month Balance
$
(c)
*For any adjustments provide explanation and supporting documentation, if applicable.
SECURED PAYMENTS REPORT
List the status of Payments to Secured Creditors and Lessors (Post Petition Only). If you have entered into a
modification agreement with a secured creditor/lessor, consult with your attorney and the United States Trustee
Program prior to completing this section).
Number
Total
Date
of Post
Amount of
Secured
Payment
Amount
Petition
Post Petition
Creditor/
Due This
Paid This
Payments
Payments
Lessor
Month
Month
Delinquent
Delinquent
TOTAL
(d)
(a)This number is carried forward from last month’s report. For the first report only, this number will be zero.
(b, c)The total of line (b) must equal line (c).
(d)This number is reported in the “Current Month” column of Schedule of Receipts and Disbursements (Page MOR-2, Line 5N).
MOR-5
ATTACHMENT 3
INVENTORY AND FIXED ASSETS REPORT
Name of Debtor:
Case Number:
Reporting Period beginning
Period ending
INVENTORY REPORT
INVENTORY BALANCE AT PETITION DATE:
INVENTORY RECONCILIATION:
Inventory Balance at Beginning of Month
PLUS: Inventory Purchased During Month
MINUS: Inventory Used or Sold
PLUS/MINUS: Adjustments or Write-downs
Inventory on Hand at End of Month
$
$
$
$
$
$
(a)
*
METHOD OF COSTING INVENTORY:
*For any adjustments or write-downs provide explanation and supporting documentation, if applicable.
INVENTORY AGING
Less than 6
months old
6 months to
2 years old
%
Greater than
2 years old
%
Considered
Obsolete
%
%
Total Inventory
=
100%*
* Aging Percentages must equal 100%.
☐ Check here if inventory contains perishable items.
Description of Obsolete Inventory:
FIXED ASSET REPORT
FIXED ASSETS FAIR MARKET VALUE AT PETITION DATE:
(Includes Property, Plant and Equipment)
(b)
BRIEF DESCRIPTION (First Report Only):
FIXED ASSETS RECONCILIATION:
Fixed Asset Book Value at Beginning of Month
MINUS: Depreciation Expense
PLUS: New Purchases
PLUS/MINUS: Adjustments or Write-downs
Ending Monthly Balance
$
$
$
$
$
(a)(b)
*
*For any adjustments or write-downs, provide explanation and supporting documentation, if applicable.
BRIEF DESCRIPTION OF FIXED ASSETS PURCHASED OR DISPOSED OF DURING THE REPORTING
PERIOD:
(a)This number is carried forward from last month’s report. For the first report only, this number will be the
balance as of the petition date.
(b)Fair Market Value is the amount at which fixed assets could be sold under current economic conditions.
Book Value is the cost of the fixed assets minus accumulated depreciation and other adjustments.
MOR-6
ATTACHMENT 4A
MONTHLY SUMMARY OF BANK ACTIVITY - OPERATING ACCOUNT
Name of Debtor:
Case Number:
Reporting Period beginning
Period ending
Attach a copy of current month bank statement and bank reconciliation to this Summary of Bank Activity. A
standard bank reconciliation form can be found at http://www.usdoj.gov/ust/r21/reg_info.htm. If bank accounts
other than the three required by the United States Trustee Program are necessary, permission must be obtained from
the United States Trustee prior to opening the accounts. Additionally, use of less than the three required bank
accounts must be approved by the United States Trustee.
NAME OF BANK:
BRANCH:
ACCOUNT NAME:
ACCOUNT NUMBER:
PURPOSE OF ACCOUNT:
OPERATING
Ending Balance per Bank Statement
Plus Total Amount of Outstanding Deposits
Minus Total Amount of Outstanding Checks and other debits
Minus Service Charges
Ending Balance per Check Register
$
$
$
$
$
*
**(a)
*Debit cards are used by
**If Closing Balance is negative, provide explanation:
The following disbursements were paid in Cash (do not includes items reported as Petty Cash on Attachment
4D: ( ☐ Check here if cash disbursements were authorized by United States Trustee)
Date
Amount
Payee
Purpose
Reason for Cash Disbursement
TRANSFERS BETWEEN DEBTOR IN POSSESSION ACCOUNTS
“Total Amount of Outstanding Checks and other debits”, listed above, includes:
$________________Transferred to Payroll Account
$________________Transferred to Tax Account
(a) The total of this line on Attachment 4A, 4B and 4C plus the total of 4D must equal the amount reported as
“Ending Balance” on Schedule of Receipts and Disbursements (Page MOR-2, Line 7).
MOR-7
ATTACHMENT 5A
CHECK REGISTER - OPERATING ACCOUNT
Name of Debtor:
Case Number:
Reporting Period beginning
Period ending
NAME OF BANK:
BRANCH:
ACCOUNT NAME:
ACCOUNT NUMBER:
PURPOSE OF ACCOUNT:
OPERATING
Account for all disbursements, including voids, lost checks, stop payments, etc. In the
alternative, a computer generated check register can be attached to this report, provided all the
information requested below is included.
DATE
CHECK
NUMBER
PAYEE
PURPOSE
TOTAL
AMOUNT
$
MOR-8
ATTACHMENT 4B
MONTHLY SUMMARY OF BANK ACTIVITY - PAYROLL ACCOUNT
Name of Debtor:
Case Number:
Reporting Period beginning
Period ending
Attach a copy of current month bank statement and bank reconciliation to this Summary of Bank Activity.
A standard bank reconciliation form can be found at http://www.usdoj.gov/ust/r21/reg_info.htm.
NAME OF BANK:
BRANCH:
ACCOUNT NAME:
PURPOSE OF ACCOUNT:
ACCOUNT NUMBER:
PAYROLL
Ending Balance per Bank Statement
Plus Total Amount of Outstanding Deposits
Minus Total Amount of Outstanding Checks and other debits
Minus Service Charges
Ending Balance per Check Register
$
$
$
$
$
*
**(a)
*Debit cards must not be issued on this account.
**If Closing Balance is negative, provide explanation:
The following disbursements were paid by Cash: ( ☐ Check here if cash disbursements were authorized
by United States Trustee)
Date
Amount
Payee
Purpose
Reason for Cash Disbursement
The following non-payroll disbursements were made from this account:
Date
Amount
Payee
Purpose
Reason for disbursement from this
account
_____
_____
_____
(a)The total of this line on Attachment 4A, 4B and 4C plus the total of 4D must equal the amount reported as
“Ending Balance” on Schedule of Receipts and Disbursements (Page MOR-2, Line 7).
MOR-9
ATTACHMENT 5B
CHECK REGISTER - PAYROLL ACCOUNT
Name of Debtor:
Case Number:
Reporting Period beginning
Period ending
NAME OF BANK:
BRANCH:
ACCOUNT NAME:
ACCOUNT NUMBER:
PURPOSE OF ACCOUNT:
PAYROLL
Account for all disbursements, including voids, lost payments, stop payment, etc. In the
alternative, a computer generated check register can be attached to this report, provided all the
information requested below is included.
DATE
CHECK
NUMBER
PAYEE
PURPOSE
TOTAL
AMOUNT
$
MOR-10
ATTACHMENT 4C
MONTHLY SUMMARY OF BANK ACTIVITY - TAX ACCOUNT
Name of Debtor:
Case Number:
Reporting Period beginning
Period ending
Attach a copy of current month bank statement and bank reconciliation to this Summary of Bank Activity. A
standard bank reconciliation form can be found on the United States Trustee website,
http://www.usdoj.gov/ust/r21/index.htm.
NAME OF BANK:
BRANCH:
ACCOUNT NAME:
ACCOUNT NUMBER:
PURPOSE OF ACCOUNT:
TAX
Ending Balance per Bank Statement
$
Plus Total Amount of Outstanding Deposits
$
Minus Total Amount of Oustanding Checks and other debits $
Minus Service Charges
$
Ending Balance per Check Register
$
*
**(a)
*Debit cards must not be issued on this account.
**If Closing Balance is negative, provide explanation:
The following disbursements were paid by Cash: ( ☐ Check here if cash disbursements were authorized by
United States Trustee)
Date
Amount
Payee
Purpose
Reason for Cash Disbursement
The following non-tax disbursements were made from this account:
Date
Amount
Payee
Purpose
Reason for disbursement from this account
(a)The total of this line on Attachment 4A, 4B and 4C plus the total of 4D must equal the amount reported as
“Ending Balance” on Schedule of Receipts and Disbursements (Page MOR-2, Line 7).
MOR-11
ATTACHMENT 5C
CHECK REGISTER - TAX ACCOUNT
Name of Debtor:
Case Number:
Reporting Period beginning
Period ending
NAME OF BANK:
BRANCH:
ACCOUNT NAME:
ACCOUNT #
PURPOSE OF ACCOUNT:
TAX
Account for all disbursements, including voids, lost checks, stop payments, etc. In the
alternative, a computer-generated check register can be attached to this report, provided all the
information requested below is included.
http://www.usdoj.gov/ust.
CHECK
DATE NUMBER
PAYEE
PURPOSE
AMOUNT
TOTAL
(d)
SUMMARY OF TAXES PAID
Payroll Taxes Paid
Sales & Use Taxes Paid
Other Taxes Paid
TOTAL
(a)
(b)
(c)
_________ (d)
(a) This number is reported in the “ Current Month” column of Schedule of Receipts and Disbursements
(Page MOR-2, Line 5O).
(b) This number is reported in the “ Current Month” column of Schedule or Receipts and Disbursements
(Page MOR-2, Line 5P).
(c) This number is reported in the “ Current Month” column of Schedule of Receipts and Disbursements
(Page MOR-2, Line 5Q).
(d) These two lines must be equal.
MOR-12
ATTACHMENT 4D
INVESTMENT ACCOUNTS AND PETTY CASH REPORT
INVESTMENT ACCOUNTS
Each savings and investment account, i.e. certificates of deposits, money market accounts, stocks
and bonds, etc., should be listed separately. Attach copies of account statements.
Type of Negotiable
Instrument
Face Value
Purchase Price
Date of Purchase
Current
Market Value
TOTAL
(a)
PETTY CASH REPORT
The following Petty Cash Drawers/Accounts are maintained:
Location of
Box/Account
TOTAL
(Column 2)
Maximum
Amount of Cash
in Drawer/Acct.
(Column 3)
(Column 4)
Amount of Petty
Difference between
Cash On Hand (Column 2) and
At End of Month
(Column 3)
$
(b)
For any Petty Cash Disbursements over $100 per transaction, attach copies of receipts. If
there are no receipts, provide an explanation
TOTAL INVESTMENT ACCOUNTS AND PETTY CASH(a + b)
$
(c)The total of this line on Attachment 4A, 4B and 4C plus the total of 4D must equal the
amount reported as “Ending Balance” on Schedule of Receipts and Disbursements (Page
MOR-2, Line 7).
MOR-13
(c)
ATTACHMENT 6
MONTHLY TAX REPORT
Name of Debtor:
Case Number:
Reporting Period beginning
Period ending
TAXES OWED AND DUE
Report all unpaid post-petition taxes including Federal and State withholding FICA, State sales
tax, property tax, unemployment tax, State workmen's compensation, etc.
Name of
Taxing
Authority
TOTAL
Date
Payment
Due
Description
Amount
$
MOR-14
Date Last
Tax Return
Filed
Tax Return
Period
ATTACHMENT 7
SUMMARY OF OFFICER OR OWNER COMPENSATION
SUMMARY OF PERSONNEL AND INSURANCE COVERAGES
Name of Debtor:
Case Number:
Reporting Period beginning
Period ending
Report all forms of compensation received by or paid on behalf of the Officer or Owner during the month. Include
car allowances, payments to retirement plans, loan repayments, payments of Officer/Owner’s personal expenses,
insurance premium payments, etc. Do not include reimbursement for business expenses Officer or Owner incurred
and for which detailed receipts are maintained in the accounting records.
Payment
Name of Officer or Owner
Title
Description
Amount Paid
PERSONNEL REPORT
Full Time
_________
Number of employees at beginning of period
Number hired during the period
Number terminated or resigned during period
Number of employees on payroll at end of period
Part Time
_________
CONFIRMATION OF INSURANCE
List all policies of insurance in effect, including but not limited to workers' compensation, liability, fire, theft,
comprehensive, vehicle, health and life. For the first report, attach a copy of the declaration sheet for each type of
insurance. For subsequent reports, attach a certificate of insurance for any policy in which a change occurs during
the month (new carrier, increased policy limits, renewal, etc.).
Agent
and/or
Carrier
Phone
Number
Policy
Number
Coverage
Type
Expiration
Date
Date
Premium
Due
__________
The following lapse in insurance coverage occurred this month:
Policy
Type
Date
Lapsed
Date
Reinstated
Reason for Lapse
Check here if U. S. Trustee has been listed as Certificate Holder for all insurance policies.
MOR-15
ATTACHMENT 8
SIGNIFICANT DEVELOPMENTS DURING REPORTING PERIOD
Information to be provided on this page, includes, but is not limited to: (1) financial transactions that are not
reported on this report, such as the sale of real estate (attach closing statement); (2) non-financial transactions, such
as the substitution of assets or collateral; (3) modifications to loan agreements; (4) change in senior management,
etc. Attach any relevant documents.
We anticipate filing a Plan of Reorganization and Disclosure Statement on or before
MOR-16
.